Liver Enzymes AST and ALT Levels: What Does It Mean When They Are Elevated

June 30, 2021

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While going for a series of routine blood tests can be overwhelming, it is still important to understand the test results and what they could mean for your health. Out of which, one such common blood test to undergo is the liver function test (LFT).

The purpose of a Liver Function Test is to examine the various liver enzymes levels in your body. Liver enzymes are produced by liver cells. When infected or inflamed, these injured liver enzymes will leak into the bloodstream – resulting in a condition otherwise known as elevated liver enzymes.

While liver enzyme levels may be temporarily elevated and do not pose much of a concern, it’s crucial to know that they may signal some underlying issues as well. Let’s take a look at the elevation of two enzymes, ALT and AST, and what you can do to regulate these enzyme levels.

What is the AST and ALT?

When there are high levels of ALT and AST, it signals that the liver is infected and inflamed, hence releasing both enzymes into the bloodstream at a rate higher than usual

Possible causes include hepatitis B and C, side effects from medication, non-alcoholic fatty liver disease (NAFLD) and alcohol.

As one of the most common chronic liver disorders in Singapore, NAFLD is a possible cause of an abnormal ALT and AST. Most patients with NAFLD do not have symptoms. In some patients, they may experience upper abdominal discomfort or tiredness. Look out for signs of severe liver condition such as jaundice and gastrointestinal bleeding if it has progressed to liver hardening.

If persistent increments in your AST and ALT levels are observed without any visible health issues, it’s best to consult a professional gastroenterologist for further evaluation. This can come in the form of screening for liver disease or an ultrasound of the liver, if necessary.

What is considered to be an abnormal AST/ALT ratio?

The AST/ALT ratio tells you the relative concentrations of the enzymes aspartate transaminase (AST) and alanine transaminase (ALT) in your blood.

A typical AST/ALT ratio would be less than 1. Sometimes, minor increments in AST/ALT ratio levels can be observed after vigorous exercise or suggest signs of skeletal muscle injury. But, an average of 70% of patients with alcoholic liver disease have an AST/ALT ratio of more than 2.

How do I regulate my AST and ALT levels?

But not to worry, lowering your AST and ALT levels can be achieved by changing lifestyle habits. For instance, cultivating a habit of regular exercise would improve insulin sensitivity and reduce liver inflammation.

Another way to keep your AST and ALT levels in check is to review your diet. Consider reducing your sugar intake and animal fat consumption. These foods can over-work your liver cells. Instead, consume foods rich in folate and the water-soluble B vitamin. Folate is key in helping your liver function at its best, so include foods such as avocado and spinach as part of your diet.


When it comes to protecting your liver, it’s crucial to keep your AST and ALT levels in check to be aware of potential infections or diseases you might have contracted. If your AST and ALT levels have been persistently high, consult a professional as soon as possible to steer clear of any dangerous developments.